Privacy Practices

 

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Please review it carefully.

Effective as of September 1, 2015.

The Texas Pregnancy Care Network (“TPCN”) contracts with the Texas Health and Human Services Commission (“HHSC”) to administer the Texas Alternative to Abortion Services Program (“Program”). In carrying out its obligations under the Program, TPCN may receive, transmit, or maintain protected health information regarding clients of the Program. TPCN is required by law to take reasonable steps to ensure the privacy of your health information. TPCN also is required to inform you about (i) TPCN’s uses and disclosures of your health information, (ii) your privacy rights with respect to your health information, (iii) TPCN’s duties with respect to your health information, (iv) your right to file a complaint with TPCN and with the Secretary of HHS, and (v) the person or office to contact for further information about the Plan’s privacy practices.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your health information

You can ask to see or get an electronic or paper copy of health information we have about you. If we maintain the information, we will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your health information

You can ask us to correct health information that we maintain about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a paper copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us using the information on page 1. You can file a complaint with the U.S. Department o f Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.pv/ocr/RrivagJhipaa/comRlaints/.We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation

If you are not able to tell us your preferences, for example of you are unconscious, we may share your information if we believe it is in your best interest. We also may share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes

Our Uses and Disclosers:

The following describes the ways we may use and disclose health information that identifies you. Except for the purposes described below, we will use and disclose your health information only with your written permission. You may revoke such permission at any time by writing to our Privacy Officer. Electronic Disclosure. Your health information may be subject to electronic disclosure. How do we typically use or share your health information? We typically use or share your health information in the following ways:

Treatment

You can ask to see or get an electronic or paper copy of health information we have about you. If we maintain the information, we will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Example: We may give health information to doctors, nurses, technicians, or  other personnel who are involved in your medical care and need the information to provide you with medical care. We may also contact you about treatment alternatives or health-related benefits and services that may be of interest to you.

Payment

We may use and disclose health information so that we or others may bill and receive payment for the services you received.

Example: We may give your service provider health information about you so the service provider can receive reimbursement for your treatment.

Health Care Operations

We may have use or disclose health information in connection with the Program’s administrative functions.

Example: We may use and disclose health information to verify and process requests for payment, to respond to eligibility and benefit inquiries from providers, and to prepare and provide reports to HHSC as required under the Program.

How else can we use or share your health information?

We are allowed or required to share Health Information in other ways-usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share Health Information for these purposes. For more information see:  www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you::

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such a s military, national security, and presidential protective
    services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Business Associates

We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we contract with business associates to perform functions necessary to the Program, including direct client services delivery and maintenance and storage of data for reimbursement processing. All of our business associates are obligated to protect the privacy o f your information and are not allowed to use or disclose any information other than a s specified in our contract.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information visit: HHS.gov Health Information Privacy.

Changes to the Terms of this Notice: We can change the terms of this notice, and the changes will apply to all protected health information we have about you. The new notice will be available upon request, in our office, and on our website.

Contact Information: If you feel your rights have been violated, you may file a complaint via email at the following email address: OCRComplaint@hhs.gov. Alternatively, written complaints also may be filed at the following address: Region VI, Office for Civil Rights U.S. Department of Health and Human Services 1301 Young Street, Suite 1169 Dallas, TX 75202 Voice phone: 214-767-4056 Fax: 214-767-0432 TDD: 214-767-8940 We will not retaliate against you for filing a complaint.

Who to contact at TPCN for more information? If you have questions regarding this notice or the subjects addressed in it, you may contact the following individual: Executive Director, 1101 South Capital of Texas Highway, Bldg. K, Ste. 250, Austin, Texas 78746; ph: 512-637-7011.